Jinna Kim, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00643100 Issued in NJ

Practice address

121 Broad Ave
Palisades Park, NJ 07650-1441

Phone

(201) 346-1500

NPI assigned

Sep 14, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

EyewellnissGroup PAC ID 6406222488, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eyewellniss

  • Health Service Clinic/Center
  • Livingston, NJ
  • NPI 1578298535
  Medicare reassignment Care Compare group NPD
• Family Eye Clinic, Inc.

  • Optometrist
  • Palisades Park, NJ
  • NPI 1639301450
  NPD (past)
• Martin Sung Kim, O.D., Inc.

  • Optometrist
  • Palisades Park, NJ
  • NPI 1851337703
  NPD (past)
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)
• Main Street Clinic, LLC

  • Pediatrics Physician
  • Pell City, AL
  • NPI 1740895291
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379116800000",
    "number": "1972853257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501441",
            "telephone_number": "201-346-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501441",
            "telephone_number": "201-346-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JINNA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2013-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00643100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Dongsoo Kim
• Hayoung Kim
• Hwallan Kim
• Hyunah Melanie Kim, BSN, MSN, FNP
• Ji Myung Kim
• John J Kim, O.D.
• Jonathan Jaeyoung Kim, D.C.
• Julia E. Kim, O.D.
• Jung H Kim, DDS
• Justin Kim, MDPP COACH

• Optometrist in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.